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Prevalence of Inferobasal Myocardial Crypts Among Patients Referred for Cardiovascular Magnetic Resonance.
MedLine Citation:
PMID:  24508667     Owner:  NLM     Status:  Publisher    
BACKGROUND: -Crypts or clefts in the left ventricular inferobasal myocardium have been detected by cardiovascular magnetic resonance (CMR), but the extent to which they represent pre-phenotypic markers of hypertrophic cardiomyopathy (HCM) or incidental structural variants remains controversial.
METHODS AND RESULTS: -We examined retrospectively the routine vertical long axis cines in 686 consecutive patients (48±20 years, 55% male) referred for CMR. Crypts were identified in 46 (6.7%), 17 being among patients (8.7% of 196) with otherwise normal CMR findings and without known family history of HCM. Higher percentages were found in patients with HCM (16%), myocarditis (15%) and hypertension (14%), but without reaching statistical significance (p=0.12). Only one (5%) of 20 phenotype negative HCM family members had a visible crypt. Relative to those without, patients with crypts had lower indexed left ventricular end-systolic volumes (p=0.042) and higher indexed left and right ventricular stroke volumes (p=0.007 and p=0.015) and ejection fractions (p=0.003 and p=0.021). Crypts tended to narrow in systole, varying slightly in size, shape and number, without obvious group-related features.
CONCLUSIONS: -Single or paired inferobasal myocardial crypts were an occasional, by no means rare finding among patients referred for CMR without a pre-test suspicion of HCM. This, together with similar previous findings in a cohort of healthy volunteers, supports their being regarded, in such individuals, as incidental variants of local myocardial structure, unlikely to require further investigation. However, a larger registry-type study may be justified to investigate the clinical implications of multiple crypts, especially if associated with HCM family history.
Joanna Petryka; A John Baksi; Sanjay K Prasad; Dudley J Pennell; Philip J Kilner
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-2-7
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  -     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-2-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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